The Doctor of Nursing Practice for Entry Into Advanced Practice

The Controversy Continues as 2015 Looms

Sandra Bellini, DNP, APRN, NNP-BC, CNE; Regina M. Cusson, PhD, APRN, NNP-BC, FAAN


NAINR. 2012;12(1):12-16. 

In This Article

Societal Implications for Health Professions Education

It comes as no surprise to anyone that the health care needs of the United States are projected to grow significantly over the next 20 years, as the number of Americans older than 65 years is projected to encompass 21% of the total population by 2050.[10] In anticipation, the nation's health care system has come under much scrutiny over the past 10 years. How will the health care needs of all our citizens be met? As an initial step, the recent passage of the Affordable Care Act, the most historic piece of health care legislation since the 1965 passage of Medicare and Medicaid, begins to address the health care needs of a nation.[11] At the request of the federal government, both the Institute of Medicine (IOM) and the Carnegie Foundation for the Advancement of Teaching have published reports and recommendations in recent years focused on the need for sweeping changes in health professions education.[11] the IOM publications,[12,14] in context with the AACN position statement on the DNP,[2] the absolute congruence of the documents is striking. Across publications, several themes are consistent: Nurses, especially advanced practice nurses, will need to practice to the fullest extent of their licensure; nurses will need advanced education and leadership training; nurses need to be educated differently than in the past with new emphasis on evidence-based practice, quality outcomes, patient safety, systems-based practice, and information technologies. In addition, health professions education should be interprofessional, emphasizing the imperative need for teamwork and respect across disciplines.[16] Perhaps AACN's call for doctoral education for entry into advanced practice was simply ahead of its time, yet right on target. By all accounts, nursing stands to play a major role in the future of national health care, but needs to take an active role to ensure its future.

Whatever one's opinion regarding the AACN position statement,[2] acknowledgements of foresight and leadership on the part of AACN can hardly be argued. In fact, by taking the initiative toward advanced nursing education before the notion became so widely endorsed at the national level, AACN has positioned nursing at the forefront of national health care reform through leadership, political activities, and savvy partnerships. Unlike the earlier 1965 ANA white paper,[1] in which no mention of Medicare or Medicaid was made despite the fact that both pieces of legislation were enacted in the same year, the AACN has actively sought involvement in the health care debate and taken part in the political process. In doing so, the AACN has potentially advanced its own agenda, that is, higher levels of education for nurses, yet giving nursing more power in interprofessional decision-making than we've traditionally enjoyed.[17]


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